What to Expect from a First Session with a Marriage and Family Therapist
by Marion S. Noble, MA,
If you're feeling nervous...
Whatever first causes you to seek therapy, you may be nervous or feeling anxious, not knowing what to expect. It's good to know this is normal, as doing anything the first time feels unfamiliar and takes us beyond our comfort zone. Give yourself credit for having the courage to begin this kind of growth!
When you first meet your therapist, you may have thoughts like:
• Do I like this person?
• Does he/she seem like someone I can trust?
• Does he/she seem like someone who can help me, someone who cares?
• I wonder what he/she might be thinking about me.
It's normal to have such thoughts, and you can take them as a sign of your
own 
investment in the process of growth. It is important for you to feel like
you've made a connection with the therapist--to feel that he or she is a person
you could work with.
You may still be feeling a little anxious as you fill out the preliminary paperwork. But this paperwork can be very reassuring. It can give you answers to lots of things you may have been wondering about, such as:
• Confidentiality and its limits
• The kind of therapy done by this therapist and his/her qualifications
• The fee, usually established on the phone or in the first session
• A description of the therapy process
• The availability of the therapist
• The name of the supervisor if your therapist is an intern (in California, Registered Interns must practice as the employee, and under the direct supervision of, a licensed therapist, until licensed).
• The right to terminate therapy at any time
• The "business end" of the therapeutic contract which applies to payment, insurance, cancellation policies, and other "business" issues
This first meeting, with its disclosures and paperwork, is a way for you to learn about your rights and responsibilities as a partner in the therapeutic process, so that you are fully informed as you make your decision whether to enter the therapeutic relationship. If you have specific questions, it's OK to ask them. If you have concerns, it's all right to address those too. If your questions aren't answered, or the concerns are not resolved, it's okay to decide to see someone else, or to suspend your decision. You may want to interview other therapists. Or, you may want to talk with this therapist about your reticence, and set two to four sessions as time to engage in a decision-making process. At the end of that time, you're likely to know whether you want to work with this particular therapist. If not, you can discuss termination and end counseling. The therapist should be able to provide you with other referrals if you need them.
Part of ethical practice is informing clients about their rights.
The ethical code of the American Psychological Association (1989) is: "Psychologists fully inform consumers as to the purpose and nature of an evaluative, treatment, educational or training procedure, and they freely acknowledge that clients, students, or participants in research have freedom of choice with regard to participation." These kinds of ethics apply to any mental health licensure in California.
You have a right to asks questions about your rights, the therapeutic process, and what possible outcomes you can expect from therapy. Part of the goal of therapy is to help you function more fully (and independently) and with increased objectivity. Of course, different problems require differing amounts of work, and some problems may not be solve-able (for example, you and your therapist can't change your mother-in-law, and may not be able to change your teenager's involvement with alcohol). However, you can change your response to stressors such as these, and live more fully and with less anxiety.
For questions, please contact:
Marion Noble (408) 390-3679.
E-mail Marion by clicking the mailbox link: 
Marion Noble, M.A., is a licensed Marriage and Family Therapist. She is in private practice at 1032 West Hedding Street, in San Jose, California.